WHO, COVID-19

Article by Lalita Panicker, Consulting Editor, Views, Hindustan Times, New Delhi

The World Health Organization (WHO) has estimated that nearly 15 million people—about one in every 500 globally—died from causes related to the coronavirus pandemic in 2020 and 2021 (the first two years of the pandemic), putting the toll from COVID-19 at nearly three times the number that had been officially recorded by countries. India suffered the highest toll of any country in the world, according to the report released Thursday, but most of the deaths have gone unrecorded. The 4.7 million people estimated to have died in India by the end of last year, according to WHO calculations, was nearly 10 times the official tally at that time of 481,000 deaths. India’s count has risen to about 524,000 since then. The report, which was compiled by scientists from around the world, has sparked fierce resistance from India, where government officials have denounced the health agency’s methodology and objected to the release of the report.

https://www.wsj.com/articles/who-says-15-million-have-died-from-covid-19-pandemic-11651755496

WHO revelations have prompted The Economist to reiterate its own model projects made last October that COVID caused about 18 m excess in the same period.

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The US Food and Drug Administration (FDA) has limited the use of the COVID-19 vaccine from Johnson & Johnson after reviewing the risk of life-threatening blood clots. The agency said Thursday that the J&J shot’s authorisation was now only for adults for whom other shots aren’t available or medically appropriate, or who won’t take another vaccine. The FDA said it was making the move after confirming a total of 60 cases, including nine deaths, of the clotting condition known as thrombosis with thrombocytopenia syndrome, or TTS, among the millions of people who got the J&J shot.

https://www.wsj.com/articles/fda-limits-authorized-use-of-j-j-s-COVID-19-vaccine-11651788829

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Africa’s top public health body urged all those purchasing COVID-19 vaccines for the continent to place orders with South Africa’s Aspen Pharmacare, saying the market was key to developing vaccine manufacturing on the continent. The Africa Centre for Disease Control and Prevention (CDC) said it was doing everything it could behind the scenes to prevent a situation where Aspen closes its facility due to a lack of orders.

https://www.reuters.com/business/healthcare-pharmaceuticals/africa-cdc-urges-COVID-19-vaccine-buyers-order-safricas-aspen-2022-05-05/

Meanwhile Aspen Pharmacare said it would switch about half of its COVID-19 vaccine production capacity onto other products if demand doesn’t pick up within six weeks, its CEO warned, as South Africa’s president and health officials urged more Africans to take the shots. Aspen completed a deal in March to package, sell and distribute Johnson & Johnson’s COVID-19 vaccine in what was considered a game-changing moment for an under-vaccinated continent frustrated by sluggish Western handouts.

https://www.reuters.com/business/healthcare-pharmaceuticals/safricas-aspen-slash-COVID-vaccine-capacity-within-6-weeks-if-no-orders-ceo-2022-05-05/

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Bill Gates’s career-switch from entrepreneur and philanthropist to crusading author coming along developing nicely. It is just over a year since he published “How to Avoid a Climate Disaster”. Now Gates is back with “How to Prevent the Next Pandemic”. The Economist’s podcast on science and technology features an interview with Mr Gates on his views on stopping new pathogens from becoming health emergencies. The weekly edition goes on to explain why his proposals are worth exploring

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From the earliest days of the pandemic, scientists have hoped that interferons, a family of potent proteins that are the body’s own first line of defence against viruses, could become weapons against SARS-CoV-2. Because the virus effectively blunts the interferon response, researchers thought providing extra interferons could counter it. But for 2 years, interferons have disappointed in trials in hospitalized patients.

Now, a strikingly positive result from a large trial of non-hospitalized, high-risk people in Brazil has revived hopes. In a study of more than 1,900 people, those who received a single shot of a drug called peginterferon lambda within 7 days of developing symptoms of COVID-19 were half as likely to be hospitalized or to endure lengthy emergency room visits as those who received a placebo. The effect, which the trial’s sponsor, Eiger BioPharmaceuticals, reported in a press release, was seen across many SARS-CoV-2 variants, including Omicron.

Eiger said  it plans to apply for an emergency use authorization for the shot from the FDA by 30 June. It plans to make full data from the trial available at that time.

Earlier a much smaller trial in younger outpatients with early, uncomplicated SARS-CoV-2 infection found the Eiger injection did not reduce symptom duration or the time it took people to clear the virus. The scientists who led that trial agree. “Until we see a peer-reviewed publication, I am cautious re[garding] press release[s] from companies,” Upinder Singh, an infectious diseases physician at the Stanford University School of Medicine, said in an email.

www.science.org/content/article/interferon-therapy-shows-striking-results-against-COVID-19

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Following a meeting with the Chinese Olympic Committee, the Olympic Council of Asia said that the 19th Asian Games, set to be held in the Chinese city of Hangzhou in September, would be postponed and new dates announced “in the near future”. China continues to battle a spread of COVID-19 cases.

The Asian Youth Games, also to be held in China in December in Shantou, will be cancelled as the games had been postponed once last year.

Another major event that China was to host this summer, the World University Games, has also been postponed. The International University Sports Federation (FISU) said the games, to be held in Chengdu, would likely be held next year.

The postponements underlined the costs of China’s “zero-COVID” strategy. The cities had already prepared venues for the events and extensive arrangements to welcome athletes from around the world.

While the rest of the world has opened up and returned to some form of normalcy, China remains the only country still closed to the world and following a strict “zero-COVID” approach. China still bars most international travellers.

That approach led to a harsh lockdown of Shanghai for more than one month, with many of the city’s 26 million residents still under some form of restrictions. Beijing, meanwhile, has carried out repeated mass testing and closed schools as it deals with cases.

Amid growing criticism of the stringent measures, the ruling Communist Party’s top leadership met on Thursday and issued a strong signal to reaffirm that the current policy would remain in place.

A meeting of the Politburo Standing Committee chaired by President Xi Jinping said the “zero-COVID” approach would continue and warned those who questioned it, saying that the Communist Party would “resolutely oppose” and “resolutely struggle” against those who doubted the current policy.

www.thehindu.com/sport/other-sports/asian-games-2022-in-china-postponed-amid-COVID-resurgence/article65387663.ece?

Meanwhile COVID-hit Beijing returned to work Thursday after a subdued five-day Labour Day break. The holiday was devoid of the usual trips across the country or lavish family dinners, as China pledged to fight any criticism of its uncompromising “zero-COVID” policy. The long break is usually one of the most lucrative times of the year for restaurants, hotels and other businesses in China. This year, travellers spent 43% less than in 2021, data showed on Thursday

https://www.reuters.com/world/china/beijing-returns-work-after-5-day-break-high-alert-COVID-2022-05-05/

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www.nytimes.com/2022/05/04/health/COVID-variants-gamma-iota-mu.html?

In early 2021, scientists in Colombia discovered a worrisome new coronavirus variant. This variant, eventually known as Mu, had several troubling mutations that experts believed could help it evade the immune system’s defences.

Over the following months, Mu spread swiftly in Colombia, fuelling a new surge of COVID-19 cases. By the end of August, it had been detected in dozens of countries, and the World Health Organization had designated it a “variant of interest.”

And then it fizzled out. Today, the variant has all but vanished.

For every Delta or Omicron there is a Gamma, Iota or Mu, variants that drove local surges but never swept to global dominance. And while understanding Omicron remains a critical public health priority, there are lessons to be learned from these lesser lineages, experts say.

Studies of the also-rans have shed light on surveillance gaps and policy blunders — providing more evidence that America’s international travel bans were not effective — and on what makes the virus successful, suggesting that in the early phase of the pandemic, transmissibility was more important than immune evasion.

The research also highlights how much context matters; variants that make an impact in some places never gain a foothold in others. As a result, predicting which variants will surge to dominance is difficult, and staying on top of future variants and pathogens will require comprehensive, nearly real-time surveillance.

The coronavirus is constantly changing, and most new variants never get noticed or named. But others raise alarms, either because they quickly become more common or because their genomes look ominous.

Both were true of Mu as it spread in Colombia. Several of the mutations in its spike protein had been documented in other immune-evasive variants, including Beta and Gamma.

In the new study, which has not yet been published in a scientific journal, scientists compared Mu’s biological characteristics to those of Alpha, Beta, Delta, Gamma and the original virus. Mu did not replicate faster than any other variant, they found, but it was the most immune-evasive of the bunch — more resistant to antibodies than any known variant besides Omicron.

By analysing the genomic sequences of Mu samples collected from all over the world, the researchers reconstructed the variant’s spread. They concluded that Mu had likely emerged in South America in mid-2020. It then circulated for months before it was detected.

Mu presented another challenge, too. It happened to have a type of mutation, known as a frameshift mutation, that was rare in coronavirus samples.

That complication created delays in the public sharing of Mu sequences. The time that elapsed between when a virus sample was collected from a patient and when it was made publicly available on GISAID was consistently longer for Mu cases than for Delta cases, the researchers found.

Combine these surveillance gaps with Mu’s immune evasiveness and the variant seemed poised to take off. But that is not what happened. Instead, Mu radiated from South and Central America to other continents but did not circulate widely once it got there, the scientists found.

That was likely because Mu found itself competing with an even more formidable variant: Delta. Delta was not as skilled at dodging antibodies as Mu, but it was more transmissible. So, in the end, Delta spread more widely.